Rural Maternity and Obstetrics Management Strategies Program - Alabama has consistently ranked among the worst for infant and maternal health in the U.S. Infant and maternal mortality rates are above the U.S. average. Disparities by race and ethnicity persist, and access issues exacerbate these in rural areas of the state. Co-morbid and chronic conditions, limited insurance coverage, a total lack of providers in certain regions, and economic barriers for women compound health issues for the most vulnerable populations in AL. Women and children in rural areas are affected more acutely by these and other critical problems due to dwindling access to primary, prenatal, and labor and delivery services. Through HRSA’s Rural Maternity and Obstetrics Management Strategies Program (HRSA-20-041) University of Alabama at Birmingham (UAB) School of Nursing, in partnership with the UAB School of Public Health (UAB SOPH), and a network of academic, government, non-profit, payer, and community partners across the state will work to achieve the following goals: 1. Establish and sustain a Rural Maternal Network (RMN), 2. Expand and preserve access to comprehensive maternity and obstetrics services across HRSA-designated rural areas. 3. Reduce maternal and infant mortality, 4. Strengthen system-level coordination and data sharing, build and sustain a maternal health workforce, and 5. Ensure long-term financial and operational sustainability of maternal services and training. UAB will pursue the following objectives to meet the goals: • Address low access in areas where pre- and post-natal care is absent through mobile and risk-based telehealth services; • Strengthen the workforce by increasing the number and reach of certified nurse midwives (CNM) into rural areas of the state, and promote interprofessional training and collaboration between rural physicians, doulas, lactation consultants, and mental health professionals; • Provide support to rural hospitals without labor and delivery services through education and training conducted by CNMs; • Enhance data-sharing systems to reduce the burden on patients and facilities when managing or transferring care; • Integrate data to create a risk profile for patients to determine the appropriate course of prenatal and delivery care By the end of the four-year project period, UAB and network partners like USA Health will have demonstrated an increase in rural prenatal care access in at least twelve counties in the south-central regions of Alabama, with a plan for sustainability and scaling of activities to all of Alabama’s rural communities. UAB will also demonstrate a proof of concept for a reimbursable system that partners CNMs with family medicine obstetricians and maternal fetal medicine specialists using a mix of mobile and telehealth care delivery. UAB will assemble and produce a list of best practices for care coordination between prenatal care providers, Nurse Family Partnership, doulas, pediatricians, and mental health professionals. UAB will demonstrate an improvement in prenatal care entry for rural patients by at least 10%, and an improvement in entry to higher levels of care for management of chronic disease or complex conditions by at least 50%.
